| Wandering coronary stenoses: adrenaline-induced coronary artery spasm in a patient resuscitated from cardiac arrest. | |
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MedLine Citation:
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PMID: 20517968 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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A 68-year-old ex-smoker man with history of allergy, presented to the emergency department with progressive dyspnea one hour following self-medication with aspirin for troublesome headache. Examination revealed diffuse sibilant rhonchi over both lungs. Electrocardiogram showed signs of ischemia. In the intensive care unit, he received bronchodilators, nitroglycerin, and aspirin. Bronchospasm increased, and then the patient was shocked, and developed cardiac arrest. After resuscitation, he was kept on mechanical ventilation and adrenaline infusion. He was scheduled for coronary angiography. The left system demonstrated stenosis of the mid-segment of the left anterior descending artery (LAD), which was totally occluded distally, stenosis of the left circumflex (LCx) with a mild plaque in its marginal branch. The right system demonstrated stenosis of the mid-segment of the right coronary artery (RCA), with diffusely diseased posterior descending artery (PDA) and posterolateral left ventricular branch (PLLV). Successful direct stenting was performed to the RCA. Angiography demonstrated worsening of the distal stenosis in the PLLV and complete occlusion of the PDA. Balloon dilatation of the PLLV was adequate, but dilatation of the PDA failed. Repeat angiography of the left system revealed an occluded LCx with critical stenosis of its marginal branch; nevertheless, the LAD was as before. Balloon dilatation of the distal LAD was attempted without improvement, yet, angiography therein, demonstrated "migration" of the stenoses in the LCx. The procedure was halted, adrenaline infusion discontinued, and an intra-aortic balloon pump inserted. The patient was discharged one day later. Follow-up angiography 6 months later demonstrated mild atherosclerotic coronary irregularities. |
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Authors:
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Salvatore Battaglia; Wail Nammas |
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Publication Detail:
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Type: Case Reports; Journal Article |
Journal Detail:
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Title: Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions Volume: 75 ISSN: 1522-726X ISO Abbreviation: Catheter Cardiovasc Interv Publication Date: 2010 Jun |
Date Detail:
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Created Date: 2010-06-02 Completed Date: 2010-09-07 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 100884139 Medline TA: Catheter Cardiovasc Interv Country: United States |
Other Details:
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Languages: eng Pagination: 1056-9 Citation Subset: IM |
Affiliation:
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Department of Cardiology, Hôpital Européen Georges Pompidou, Paris, France. salvatore.battaglia@egp.aphp.fr |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adrenergic Agonists
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administration & dosage,
adverse effects* Aged Angioplasty, Balloon / instrumentation Coronary Angiography Coronary Stenosis / chemically induced*, radiography, therapy Coronary Vasospasm / chemically induced*, radiography, therapy Epinephrine / administration & dosage, adverse effects* Heart Arrest / therapy* Humans Infusions, Intravenous Intensive Care Intra-Aortic Balloon Pumping Male Respiration, Artificial Resuscitation* Stents Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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0/Adrenergic Agonists; 51-43-4/Epinephrine |
| Comments/Corrections | |
Comment In:
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Catheter Cardiovasc Interv. 2010 Jun 1;75(7):1060-1
[PMID:
20517969
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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